Four of a Kind (11 page)

The flop cards made her pulse beat faster: another ace, three of hearts, four of spades. Junk cards, rags, except that ace. Baseball Cap bet $500
.
Maybe he had the fourth ace in the pocket? The Black Queen wanted to draw them in, lull them into her trap, so she called the $500. No raise. Not yet. She wanted to bide her time. Get as much of their money as she could. The Asian dude called, too
.

The turn: three of diamonds. The Black Queen had a full house. Aces over threes. She couldn’t lose, unless … stealing a glance at the other players, she tried to guess. Were either of them holding a pair of threes in the pocket? That was the only way they could beat her
.

The Black Queen was willing to pay to find out. She called Asian’s $1,000 bet. Baseball Cap folded. Asian dealt the river card, a three of clubs
.

Damn,
she thought. Triple on board. A measly pocket three could beat her now, and from the look on Asian’s face, he might have it. Might. If he did, he’d bet big, and then she’d know. But the bet was to her. She could check, and see if he put money on the table. Or she could bet big, scare him into folding. The pot was a few thousand already
.

“Five hundred,” she said lazily, casually
.

Asian said, “Reraise, all in.”

The Black Queen called. She went in all the way, her whole $4,000. Win or lose. Put up or go home
.

Time for the showdown. She went first, revealing her full house, aces and threes. Asian turned over his blinds
.

No three, no three, whispered the Black Queen
.

Five of hearts. And four of spades. Full house, threes and fours
.

“Yes!” she couldn’t help shouting. “Come to Mama!” The pile of chips clicked and tumbled as she gathered her winnings. The victory hoot might’ve been a little too loud
.

The hag to her right said, “Take it easy.”

“You take it easy,” she said. “I’ll just take it.”

KNOCK.

The intent rapping on Carla’s office door broke the spell. She closed her laptop, regretfully leaving her winnings in cyberspace.

“Yes?” she asked.

Her R.N., a twenty-five-year-old woman named Tina Sanchez, opened the door and said, “What are you doing in here? I heard you shouting.”

Oh, no
, thought Carla. The Black Queen had better learn to control her mouth. “Nothing. Just reading the
Times
online.”

Tina squinted at her. “Must be a fascinating article. Three exam rooms are full,” she said, not buying Carla’s story.

“I still have another five minutes,” said Carla, who would not be rushed through her one and only break of the day, forty-five minutes for lunch.

Tina clicked her tongue, and said, “Check your watch, Mommy. You’re ten minutes late.”

Ten minutes late? That would destroy her schedule. She had patients scheduled from now until six o’clock tonight at fifteen-minute intervals, and there were
always
walk-ins.

Carla said, “Okay, I’m coming.” Tina stood with her arms folded, not leaving until Carla made a move. Why a five-foot-tall, hundred-pound twenty-five-year-old intimated large-and-in-charge Carla was beyond her comprehension. Maybe it was the way Tina called her “Mommy,” constantly reminding her of her responsibilities. Then again, Tina called all women “Mommy,” and all men “Poppy.”

Carla would not get the ten seconds of privacy she needed to quit and hide her World Class Poker CD, the disc that had become her second husband and new best friend in the last couple of weeks. From the first game—which she’d started playing reluctantly, only because she promised Bess she would at least try it—Carla was hooked. The money wasn’t real. The other players weren’t real, just impressive 3-D animations. If she won a big hand, netting thousands from an opponent, Carla felt sweet and visceral victory, not the guilty conscience of taking an actual person’s rent money. The game was pretend, and yet the thrill of winning was real.

At forty-two, Carla learned something new about herself: She liked to win. She
loved
to win.

The game was her secret. How could she explain to Claude or Tina the excitement of being a calculating, ballsy, ruthless mercenary? She was the Black Queen, a tower of confidence who made other players quake in her presence. In real life, she was an overworked, unappreciated mother and wife.

Change your name, change your personality. At age twenty-six, when she became
Dr
. Carla Smith, a new seriousness came with the suffix. When she’d become Dr. Carla
Morgan
, a wife, she transformed again, halving herself to be one with her husband. Then came Manuel and Ezekiel (aka Manny and Zeke), and Carla became Mommy, a champion worrier and humorless taskmaster. The Black Queen, the name she gave her cyberself, was young(er), wise, tough, smart, selfish, and greedy. She didn’t care about hanging arm fat, dire financial straits, raising boys in a complicated world, a Mexican standoff marriage, three patients in exam rooms, a tongue-clicking R.N. The Black Queen was Carla’s best—and worst—self.

Taking the charts from Tina, Carla exited her office, careful to close the door firmly behind her. Her pediatric clinic was located on the ground floor of Long Island College Hospital on Atlantic Avenue, serving the medical needs of downtown Brooklyn for half a century. Many of the clinic’s patients were uninsured, coming in for health crises only. It pained Carla that her walk-in patients were nearly always black and Latino from neighborhoods that were miles and light-years away from the hospital’s Brooklyn Heights location.

In exam room one, Carla smiled as she entered. A little boy was in a striped shirt of faded colors, filthy sneakers with new white laces. He smiled back. He sat on the examining room table, legs dangling. His mother, in the room’s one chair, wore work clothes, a poly-blend cobalt skirt suit. She’d had to leave work early to be here today, probably exasperated for the disruption. Tina followed her into the room and closed the door.

“Hello, Jamal. How are you feeling today?” Carla asked, while skimming his chart. Six years old. Average height, weight. Sketchy
medical history. Fewer than annual checkups, immunization schedule incomplete.

“Itchy,” he said, scratching his head.

The mother said, “I’ve been washing his hair with dandruff shampoo.”

Tina clicked her tongue. “Did you examine his scalp, Mommy?”

“Yes, I did,” said the woman, sounding offended to be asked.

Carla put on some gloves and tried to appear calm. Despite years of experience dealing with blood, plasma, excrement, vomit, boils, broken bones, open wounds, she was still grossed out by lice.

Carla said, “Why don’t I have a look?” She parted the boy’s hair. In less than five seconds, Carla counted a dozen little buggers, and a thriving crop of shiny, teardrop shaped eggs. It was Times Square in there. No wonder the kid was itchy. Carla parted another section. Along with mobs of lice, she found infected scratch divots. The boy had been clawing at himself.
For how long?
she wondered.

Meanwhile, the mother warily watched Carla. In equal parts, the look said, “Please let him be okay,” “Don’t blame me,” and “How much is this going to cost?” Carla stepped away, removed her gloves and put them in the medical waste can. If the mother thought she was saving herself time by postponing the doctor’s appointment, she was in for a shock when she found out what was in store for her now: washing all the bedding in hot water; vacuuming all the carpets, upholstery, and furniture twice; putting all stuffed animals and pillows in garbage bags for two weeks washing all of Jamal’s clothing, coats, hats, backpacks; replacing all brushes; to say nothing of the hours she’d have to spend picking through his hair with a fine-toothed steel lice comb.

“At the start of the school year, we see a lot of lice. You should report his condition to his teachers so his classmates can be checked,” said Carla. “We have a fact sheet with instructions.”

“Okay,” said the mother, impatient or … what? Resentful. Blaming the messenger.

“The eggs or nits are tough to get rid of. But if you don’t, he’ll suffer a reinfestation. Also, Jamal’s scalp is infected from scratching and he’ll need a prescription antibiotic.”

“How much is that?” asked the woman.

Carla said, “That depends on your plan.” Judging the look on the woman’s face, she didn’t have health insurance. In New York, lower-income families qualified for the affordable state plan called Child Health Plus. The paperwork was a bit challenging. A lot of overworked parents didn’t have the time or wherewithal to sort through it.

Carla said to the mother, “I should take a look at your scalp, too.”

“Me? I’m fine.”

The woman had an elaborate woven hairdo that would have to be unraveled. It probably costs quite a bit at the beauty shop. More than the antibiotics her son needed.

“The exam shouldn’t take more than a minute,” said Carla, giving it another try.

“I said I’m fine.”

Carla sighed, and made eye contact with Tina. She had her witness that Ms.—she checked Jamal’s chart—Ms. Williams refused an examination. But it wasn’t enough anymore. She’d have to get it in writing, or Ms. Williams could make a load of trouble later on if she accused Carla of negligence.

“I’m going to have to ask you to sign a piece of paper that states you refused to be examined, all right?”

Ms. Williams rolled her eyes and said, “I’m not signing anything.”

Carla, way behind schedule, was not going to argue. “Tina, please give Ms. Williams the fact sheet and instructions. You’ll notice that we recommend buying a fine, steel lice comb. The best one is from Germany and costs sixty dollars. It’s expensive, but it really works.”

“I’ll get the lice shampoo for ten bucks at the drug store.”

“That won’t kill the nits.”

“I’ll take my chances.”

“You’ll be right back here in two weeks.”

Ms. Williams groaned and asked, “What do you suggest that won’t cost me hundreds of dollars?”

Steady
, thought Carla.
She doesn’t really resent me
, she reminded herself.
It’s a tough situation. Empathy. Show empathy
. Carla said, “I know you must feel put out and upset. Getting rid of lice is a job and a half. I’m sorry to have to be the bearer of bad news.”

“Yeah,” said Ms. Williams, scooting Jamal off the exam table. “Let’s get out of here.”

“Good luck,” said Carla, quickly writing a prescription for antibiotics and forcing it on Ms. Williams before she exited the room. Taking a few deep breaths, Carla tried to find equilibrium, a calm center, the flatland of professional distance. Carla had to get there. And stay there. She had to be perfect, above reproach. Or she’d be hearing from the hospital administrators again.

At the hallway sink between exam rooms, Carla washed her hands several times, and slathered them with antibiotic gel. She pulled the chart off the door of exam room two, and entered.

Another black mother and child. She could count on one hand how many times she’d seen a black walk-in patient with her father. She saw a fair number of white and Hispanic dads. Where were the black fathers?

Her own father, Luther Smith, left when she was three. He was gone, out the door, but just around the corner, in the apartment of another woman whom he quickly impregnated and then abandoned, a cycle he repeated three more times before fleeing Brooklyn for Florida, where he lived now with yet another family. Carla’s mother, Gloria, replaced Luther with Jesus Christ.

The upside: Carla was an only child, which was rare in her neighborhood. Gloria divided her time and energy between church and Carla, sheltering her daughter, setting high standards for her academic success.

The downside: Carla was chronically lonely. She was at the top of her class, but she hadn’t had a boyfriend until college. Despite spending
Sundays in church, Carla never found spiritual comfort there. Carla believed in God and aspired to live by his laws, but she didn’t believe he bothered himself with the desires of individual people, or the entire human race. We are ants on a hill, she often thought. God had the universe to worry about.

During med school, Carla was taught day after day about the frailty of the human body, and the tissue-thin protection we had against disease. Doctors repeatedly warned, “The more we know, the less we know we can do.” For all the advances of science, healers were still in the Stone Age. To cure cancer, you had to cut out the tumor. To cure a lice infestation, you had to pick nits, one by one.

The girl in exam room two sat on the table. She looked about sixteen, but a glance at her chart put her age at thirteen. The girl looked terrified. Carla assumed the problem was gynecological.

“What can I help you with today”—she glanced at the chart—“Selina?”

The mother said, “Show her.”

Reluctantly, Selina removed her shirt. On her shoulders and chest, the girl was covered with fleshy lumps, wartlike, several dozen of them of various sizes, the larger ones like pencil erasers.